Insulin Pump VS MDI – Multiple Daily Injections

pumpvspensWhen choosing which method of taking care of your diabetes presents itself, it’s nice to have an unbiased compare/contrast list to figure out which might be best for you. So if you are thinking of switching up how you deliver insulin, keep reading.

Insulin Pump

Positives: 

  • continuous insulin delivery
  • one type of insulin used
  • increased ability to fine tune basal rates
  • microbolus possible (.025u, depends on pump brand)
  • one injection every three days (depends on what type of cannula used)
  • stores all data, example: insulin dose, dose time, active insulin, blood sugar, etc (depends on independent pump brand)
  • pump and CGM combined in one device (depending on brands used)

Possible negatives:

  • COST. Including the pump and continuous consumables needed
  • higher risk of undelivered insulin
  • subjective, but disease is visible
  • bulky and always attached
  • must be worn nearly 24/7 (excluding showering, sex, etc)
  • risk of diabetic lipohypertrophy (fat accumulation from multiple injections in same area which effects insulin absorption)
  • skin sensitivity to adhesives
  • if CGM is used, two areas with devices attached to body
  • environmentally wasteful: batteries, plastic packaging, etc

Multiple Daily Injections (MDI) includes pens or syringes

Positives of pens:

  • portable, pre-filled pens to deliver insulin as needed by injection, insulin is dialed out and pushed in
  • disease is not obviously visible
  • more options of injection sites
  • socially flexible treatment option
  • needle sizes can be customized

Possible negatives of pens:

  • insulin leakage if not held after injection for longer than 30 seconds (adequate time to prevent leakage is not exact)
  • need to inject basal insulin at same time(s) per day
  • two types of insulin needed, basal (slow release) bolus (mealtime – fast acting)
  • no way to record dosing after injected (must be pen & paper, or an app like MySugr)
  • insulin waste from priming needle
  • typically only able to inject in full 1u increments

Positives of syringes:

  • more options of injection sites
  • insulin can be injected in .5u increments
  • disease is not obviously visible
  • no insulin leakage after injection

Possible negatives of syringes:

  • must fill insulin into syringe
  • need to inject basal insulin at same time(s) per day
  • two types of insulin needed, basal (slow release) bolus (mealtime – fast acting)
  • no way to record dosing after injected (must be pen & paper, or an app like MySugr)

This list is not conclusive, and technology is advancing quickly. In the end, each individual will need to weigh the pros/cons to their own personal preferences to make a decision on which method is best. There is not a one-size-fits-all method.

Although not readily available everywhere, “smart” insulin pens could provide a great alternative to an insulin pump for those who do not want to be tethered. For example: the Pendiq insulin pen has a lot of functionality like tracking insulin dosing, insulin delivery to the .1u (beginning at .5u), Bluetooth or USB function to read data on a computer, etc. It provides a pump technology, without the attachment.

And please don’t be fooled into believing that an insulin pump provides better control. Precise control is possible with all delivery methods. Period.

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P.S. any change in diabetes management should be consulted with your doctor, but you know that already!

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